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Gradual closure of fasciotomy wounds using a vessel loop shoelace

1993; Elsevier BV; Volume: 24; Issue: 8 Linguagem: Inglês

10.1016/0020-1383(93)90040-d

1879-0267

Ian A. Harris,

Vascular Procedures and Complications

Acute compartment syndrome is reported to occur in 1.5 per cent of patients with closed tibia1 fractures treated with intramedullary nailing (McQueen et al., 1990). Treatment of acute compartment syndrome should include dermotomy as well as fasciotomy (Gaspard and Kohl, 197.5) and most of these open fasciotomies are treated by skin grafting because delayed primary closure is usually not possible (Sheridan and Matsen, 1976). Skin grafting, however, gives poor coverage and sensation to the wound, often requires immobilization of the limb and to the patient and is less appealing cosmetically. Several techniques have been described to aid closure of the wound in an attempt to avoid skin grafting (Patman and Thompson, 1970; Miller, 1990). These involve placement of static tensioning devices across the wound (paper tape or sutures) which are replaced or tightened at appropriate intervals. An alternative technique using an elastic ‘shoelace’ is described which has the advantages of providing a continuous pull on the wound edges and may be tightened without replacement and without the need for anaesthesia. Although this technique is becoming popular it has remained unreported in the literature.